Individual
FAIROUZ CHOUIKH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
2801 N GANTENBEIN AVE, PORTLAND, OR 97227-1623
(503) 413-2200
Mailing address
982 AVE. WILFRID-PELLETIER, APT. 304, STE-FOY, QC G1W 4-Y2
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
D10993
OR
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/24/2011
Last updated
03/18/2019
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